Form No :

Baba Ghulam Shah Badshah University

Rajouri – 185234 (J&K)
College of Nursing
B. Sc. NURSING ADMISSION APPLICATION FORM- 2018

Important Instructions:
i. Read the application form carefully before filling
ii. Provide all the required information. Incomplete form will be rejected. Candidate’s
recent stamp
iii. Attach attested photocopies of all relevant certificates. (10th, 12th, Category Certificate, Residence Certificate) size
iv. Calculate the age on the basis of 31st December. Minimum Age limit is 17 years and maximum age 28 years. photograph

1. Name of the Course: _____________________________________________________

2. Personal information
a. Name (Capital Letters). Leave a blank space between first, middle and last name.

b. Date of Birth ( As per Matriculation Certificate) Day Month Year

c. NAD ID: ______________________ (i) Aadhaar Based (ii) Non - Aadhaar Based

d. Father’s Name (Capital Letters). Leave a blank space between first, middle and last name.

e. Mother’s Name (Capital Letters). Leave a blank space between first, middle and last name.

3. Category to which the candidate belongs (Attach supporting document issued by the Competent Authority)

a. General / Open Yes No

b. Reserved
ST SC OBA DS/UPC Self Finance JPR RPR

4. Permanent home Address for correspondence : _________________________________________________________

__________________________________________________________________________________________________

Village : _______________________________Tehsil ________________________ District ________________________

State : ____________________________ Pin Code: _________________ Telephone No: _________________________

Mobile No 1. ____________________ Mobile No 2.________________________ Mobile No 3. ___________________

 b. Guardians Address:
Name : ______________________________________ Relationship: _______________________________________

Address : ________________________________________________________________________________________

Village :____________________________Tehsil :______________________District : __________________________

State ________________ Pin Code: ____________________Telephone No: __________________________________

Mobile No 1: _____________________ Mobile No 2: ________________________ Mobile No 2:__________________

5. Amount paid for admission application form: D.D. No. _____________________________ Bank __________________

Amount ___________________ Date :_______________________

6. Details of the Examination (s) Passed

Physics,
S. Examination Board Year Roll Total Marks Chemistry, Division
No. Passed No marks secured Biology,
English
1.

2.

3.

4.

7. Declaration by the applicant

I declare that the particulars given above are correct, in case I am admitted I undertake to abide by all rule &

regulation of the Baba Ghulam Shah University and pay all the dues by due date.

Name ___________________________________ Signature _________________________________

8. Declaration by Parent/ Guardian

My ward _________________________________ is applying for admission to __________________ course with my

consent. In case she is admitted I guarantee that she will pay all dues/ fees in time and abide by all rules &

regulations of the university.

Place _____________________

Date _____________________ Signature _____________________

2
 Baba Ghulam Shah Badshah University
Rajouri – 185234 (J&K)
College of Nursing Candidate’s
recent stamp
size
ENTRANCE TEST (ADMIT CARD) photograph
Centre Copy
Course:__________________________________ Application Form No :____________________

Name : __________________________________ D/O : _________________________________

Roll No. BGSBU /18/ _______________________ Entrance test Centre: ____________________

Entrance Test Date ________________________ Reporting Time:_________________________

Signature of the Candidate Signature of Principal

i. After signing the card, the candidate should send or submit it along with the Application form to the Principal,
College of Nursing, Rajouri.
ii. Applicants are advised to collect the cards from office of Principal, College of Nursing, Rajouri.

Baba Ghulam Shah Badshah University

Rajouri – 185234 (J&K)
College of Nursing Candidate’s
recent stamp
size
ENTRANCE TEST (ADMIT CARD) photograph
Student Copy
Course:__________________________________ Application Form No :____________________

Name : __________________________________ D/O : _________________________________

Roll No. BGSBU /18/ _______________________ Entrance test Centre: ____________________

Entrance Test Date ________________________ Reporting Time:_________________________

Signature of the Candidate Signature of Principal

 TO BE FILLED BY THE OFFICE
1. Name of the Candidate : _________________________________________________________________________

2. Name of the course : ____________________________________________________________________________

3. Marks secured in entrance test for B.Sc. Nursing.____________________________________________________

4. Rank: _________________________________________________________________________________________

5. Roll No: _______________________________________________________________________________________

6. Selection notification no:_________________________________________________________________________

7. Category and S.No. ______________________________________________________________________________

8. Details of admission fee : Amount : ___________________________D.D. No.: _____________________________

Bank: _________________________________________ Date : ___________________________________________

9. Original documents deposited:

 10th Mark sheet

 10th Certificate

 12th Mark sheet

 12th Certificate / Provisional Certificate

 Permanent Resident Certificate

 Category Certificate (if any)

 Character certificate by head of the institution last attended or

Gazetted officer

 Migration certificate

 Gap period certificate

 Affidavit.

 5 Recent Passport Size Photographs

10. Signature of the admission committee members

______________________________________ ________________________________________ ________________________________________

First member Second member Third member

Name of office Incharge : _________________________ Signature of office Incharge______________________

Date: ____________________

Signature of Principal